Plantar Fasciitis Part I

Raina and several other readers asked about plantar fasciitis.

On a house, a fascia is a flat horizontal surface just under the roof. In your body, a fascia is flat fibrous tissue that wraps your muscles and soft structures. You have fascia in several places. One is across the bottom of your feet. "Plantar” means the bottom of your foot that you "plant" on the ground. Your plantar fascia is the fascia on the bottom of your foot. Plantar fasciitis is an inflammation (-itis) of the fascia on the bottom of your foot.

Normal Plantar Fascia Action
When you walk or run with your feet facing straight ahead, the line of bending of the foot is straight from front to back. Each step gives you a nice, built-in small stretch across the bottom of your foot. As you walk, run, jump, and move, your plantar fascia transmits body weight across your foot. It is part of shock absorption for your entire leg.

How Bad Movement Mechanics Hurts
Several things can make the fascia tighten and hurt. Here are three. More to come in future posts:

1. When you walk or run with feet facing outward, the fascia loses the normal stretch. Over years of not getting its normal stretch, it becomes tight. Walking with feet facing outward also puts sideways forces on the fascia with each step. Over years, your foot can get strained. Walking with poor shock absorption, banging down heavily with each step can amplify strain forces on a tight fascia. Every step you take on a tight fascia yanks on the heel where it attaches. Eventually the heel and bottom of the foot get irritated from the yanking and start to hurt.

The tighter your Achilles and foot fascia, the more "normal" it feels to walk toe-out. In a circular problem, walking toe-outward is a common fascial tightener. It may be "natural" with tightness, but can increase tightness over time.

2. Letting ankles pronate (arches flatten) is another fascial strain. Keep your body weight evenly around the sole of your foot, not sagging inward on your arches, pressing them downward. Reader David from Belgium has made us a great short video of easily changing from rolling in on the arches to holding straight in Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches.

3. Hard sole shoes and some fasciitis braces stop the sole from getting the normal lengthening while walking, therefore stopping the pain from the stretch, giving the false impression that the injury is lessening. It is a negative cycle of shortening and continuing the source of the injury. Injections briefly make the area more prone to injury. Pain pills allow you to continue the injury process without pain telling you that it is wrong. Several kinds of anti-inflammatory and pain medicines interfere with healing. Wearing high heeled shoes raises the heel, shortening the length of the Achilles tendon, putting less stretch on the tendon, the lower leg muscles, and the fascia of the foot.

Fasciitis can be quickly stopped. It does not have to be chronic. "Doing" a few stretches does not undo a lifestyle of shortening, tightening, and straining. Use good body movement for all movement to allow it to heal and be functional.

Helpful links to move in healthy ways to stop plantar fasciitis:

• Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches
• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Arch Support Is Not From Shoes
• Better Achilles Tendon Stretch
• The book Fix Your Own Pain Without Drugs or Surgery has a section on fasciitis, the many unhealthful lifestyle contributors, and simple lifestyle fixes to build into daily life and your exercise classes.

Labels: achilles stretch, feet, fix pain, injury, plantar fasciitis, pronation, running, walking

Permalink | 4 Comments| Email Post

Post your comment

Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life

Reader Jill hasn't sent a photo yet, but her words are a beautiful picture. Her story can help many readers stop pain and improve strength and function for happier daily life.

In the post Lunges and Beans Jill commented on Celiac disorder, an immune reaction to foods with the gluten protein - principally wheat plus a few others. Symptoms can be baffling until identified as coming from gluten.

Jill writes: "I had bad and steadily worsening joint problems, especially in the knees, for ten years before I found out about my gluten sensitivity. By that time my legs were extremely weak from having been unable to put weight on a bent knee for so long.

"I let the knees heal without doing anything special for them until I hit a plateau, then started doing isometric exercise for the quads (the classic wall chair), then six months after that started running slowly on an elliptical trainer. Weightlifting exercises for quads, though, still left me hobbling.

"That's where I was when I found your blog, and since then I've been doing squats at every opportunity, which was very hard at first and got much easier. Along with the foot stretch you gave, the Achilles tendon stretch in the squats also caused tremendous improvement in my plantar fasciitis.

"After a few weeks of that you posted the stair climbing posts and now I'm having far less trouble on the large numbers of stairs I climb every day. I am shying away from lunges from long associating them with pain, but plan to get over that soon and try them (gently) according to your detailed suggestions.

"Your blog has given me an enormous number of ideas to help in rehabilitating my knees from the years of gluten, which has made an enormous improvement in my quality of life. Thank you for the care and skill you put into it."

Jill, thank you for your care and skill to write things that will help many, and to do empowered good work to shine again. I put the posts with their links. Everyone, add your favorites:

• Foot stretch - Healthy Toe Stretches
• Achilles stretch - Better Achilles Tendon Stretch
• Achilles stretch built into daily bending with half-squats - Bending Right is Fitness as a Lifestyle and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Happy knees during stair climbing - Better Exercise on the Stairs
• Plantar fasciitis - see the comments in Why So Many Aerobics Injuries?
  
• Lunges - Strengthen Legs Without Knee Pain - Standing Lunge and Strengthen and Retrain Function With The Lunge
• All posts helping knees

To stop pain and regain your life, you don't have to "do exercises" - use movement for healthy life. Have fun. Shine!

Labels: achilles stretch, celiac, feet, fix pain, knee, lunge, planter fasciitis, readers inspiring story, squat

Permalink | 1 Comments| Email Post

Post your comment

Strengthen Legs Without Knee Pain - Standing Lunge

Many people know they need to bend "right" but don't because it hurts their knees.

Bending right will not hurt knees. It will help fix one of the things that has been injuring them - bad bending habits which pressure and grind the joint.

Good bending will also give your knees the exercise they (and you) need.

Some knee patients are told to never "bend right" with a half-squat or lunge because it is bad for the knee. There are specific things about bending and straightening the knee that can increase certain kinds of pain, to be covered in future posts. Use your brain and try the following gently and safely. Done right, it should reduce knee pressure, not increase it.


How To Lunge:

1. Stand with one foot far in front of the other. Both feet face forward. (Left photo.)
2. Feet remain normal width from side-to-side, not directly in line front-to-back.
   
3. Lift your back heel. Don't turn the back toes outward. Look at your back foot and check.
4. Tuck your hip under (click "neutral spine" label for posts explaining how). You will feel a far better stretch and strengthener.
5. Bend both knees to lower straight downward. Don't touch back knee to the floor. Use leg muscles. Watch your front knee and keep it over your front heel, not sliding forward. (Right photo.)
6. Don't let your front knee sway inward.
   
7. Keep upper body upright and straight. (Right photo.)
8. Lower and rise several times, then switch legs. Keep feet still, not stepping forward and back.
   

Tips:

• To keep healthy knee positioning for the front knee, peek downward to see your front knee and foot.
• You should be able to see your front toes all the way through the bend.
• If your knee slides forward covering your toes, you are shifting weight to your knee joint and off your leg muscles. This is one of two common ways to increase knee pain while bending. Letting the front knee sway inward is another.
  
• Keep front knee steady over your front ankle, not sliding forward or inward. You will strengthen and stabilize your knees and legs instead of hurt them. You will feel more muscle use when you keep healthful positioning.

Fitness as a Lifestyle:

No need to go to a gym to do lunges. Use the lunge for daily bending around the house. It will add up to many lunges every day, built-in as fitness as a lifestyle. The posts How Often Should You Be Healthy? and Bending Right is Fitness as a Lifestyle give ideas of how to use healthy bending for normal daily life.

Benefits of the Standing Lunge:

• Strengthen leg muscles
• Strengthen the knee
• Stop harmful forces on the knees from bad bending
• Stretch the front of the hip of the rear leg
• Stretch the Achilles tendon and foot of the back leg
• Learn knee stabilization
• Practice balance
  
• Retrain healthful bending for daily life - transferring to function instead of just being an arbitrary exercise - free exercise all day
• Retrain straight upper body position for bending - more functional exercise
• Provide beneficial general exercise, warming which makes further movement easier, and healthful body movement.

Have fun practicing this now. You will need the standing lunge for tomorrow's Fast Fitness - Quick Warm Up. Enjoy.

Labels: achilles stretch, feet, knee, leg strength, leg stretch, lunge, neutral spine, squat, strength

Permalink | 4 Comments| Email Post

Post your comment

Better Exercise on the Stairs

Old woman: Come upstairs and we'll make love.

Old man: I can NOT do both.

If you would like to strengthen legs and reduce knee pain while going up stairs:

• Don't lean forward (photo 1 above)
• Stand upright (photo 2 below)
• Keep your heel down on the foot that steps up.
• Push off the whole foot, feeling the push-off through the heel. Do not push off the ball of the foot.
• When you raise one leg to step up, don't let the other leg pull and bend forward. Keep the standing leg straight (not locked straight).

Many patients who come to me, previously unable to step up a curb without pain, can climb flights without knee pain using this repositioning. Stairs become not only accessible, but a source of the exercise their legs need to strengthen and regain function.

Keep your weight back toward your heel to use leg muscles instead of putting your weight on the front of your knee. You will get knee pain relief and a built-in Achilles tendon stretch with each step. Done right, you will feel a more muscular and strong push off, making stairs easier to climb and better leg exercise. Even if you have big feet and your heel is off the step, keep your heel down instead of going up "tip-toe."

Notice if you bend forward. Instead, stand straight. The post Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs explains how hip tightness increases bent forward posture when raising one leg for kicks and activities like stairs, and shows how to hold straight body position instead, to stop tightness, and get a built-in hip and body stretch.

When descending stairs or hills, bend your knees when landing for soft shock absorption. Don't step down on a straight, locked, knee. Future posts will cover more about stairs. Have fun improving leg strength and knee function by taking the stairs during daily life in a healthy way. Send photos of your successes.

Labels: achilles stretch, fix pain, hip strength, knee, leg strength, stairs

Permalink | 0 Comments| Email Post

Post your comment

Strengthen and Retrain Function With The Lunge

The previous post Leg Exercise That Helps Your Back introduced the lunge. The lunge can be a quick effective fitness and health enhancer when you understand that you use it for real life bending, not just as an exercise to do for a set number of "reps."

The idea is to use the lunge in a healthy way instead of bending over "wrong" for all the hundreds of times you bend around the house and workplace. Then you stop one of the major sources of back (and knee) pain and degeneration while you get free built-in exercise, calorie burning, and leg and hip stretch and strengthening. The post How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending shows just how many times every day you need to know this.

Reader Ivy from New Zealand sent in the photo above right showing a great way to bend for some of the many times you need to bend to reach and get things - the standing lunge:

• Upright torso
• Bending straight downward, not forward
• Front shin pretty much vertical
• Front knee over the foot
• Front knee does not sway inward. This is key in retraining knee stability during real life bending, stairs, and other movement.
  
• Back foot facing ahead, not turned out
• Front heel down. Better for knee and gives built-in Achilles stretch
• Feet nicely spaced
• Hands free, not on front leg
• The side-seam of the jeans from hip to waist-band is vertical, not tilting forward. It is somewhat hidden by Ivy's arm, I know. But the idea is important - do not tilt your hip forward to stick the backside out in back. Keeping the side seam vertical does several important things to strengthen and stretch, and keep neutral spine that I will cover in future posts on lunging.
• Looks comfortable and doable.

When using the lunge, do not bog down in "rules" over placement. The idea is to move in simple, healthy positioning, not hold yourself rigidly.

The post The Cause of Disc and Back Pain shows more on why healthy bending is key to fitness as a lifestyle, and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending introduces the half-squat as one of several fit and healthy normal ways to bend for every day activities.

Going to a gym three times a week is not fitness as a lifestyle. Instead of "doing" exercise, lift, and bend, and move in healthy ways all the time for real fitness as a lifestyle. Give it a try and send in your success stories.

Labels: achilles stretch, hip, knee, leg strength, lunge, stretch

Permalink | 0 Comments| Email Post

Post your comment

Forensic Anthropology and Bone Density

A few weeks ago, I attended a lecture on forensic anthropology. In general, this is the study of things you can tell from human bones in a crime setting. How old was the person? Were they male or female? How big were they? What was their probable race or ancestry?

Why was I there when my work is with the living? Two main reasons. I am the science officer for the Vidocq Society, an international forensic society. I might evaluate data, for example in an aviation disaster, whether someone might have been conscious at each point when undergoing G-forces or different temperatures and amounts of oxygen after a depressurization at various altitudes. In a scuba death, I might advise on physical changes that occur with different situations. The second reason was to learn more about bones. Bones are remarkable. Your bones know a lot about you. What was your health like? Were you active? What kind of activity did you do? When I was small, I read about an archaeological dig in ancient Rome. The bones of a girl were recovered. The account stated they could tell she carried loads too heavy for her, and was therefore (in conjunction with other evidence) probably a servant or slave. I was riveted. How could they know that? I spent years after that learning more about telling how someone moved from looking at their bones.

Throughout your entire life, when you exercise you stimulate growth of new bone cells. The physical pull of muscles thickens your bones where the muscles attach. Using your arm muscles thickens arm bones. Using your legs strengthens leg bones, and so on. This is a main mechanism of how exercise prevents osteoporosis. Without exercise, you don't stimulate enough new cells to counter the normal loss as old ones break down. Your bones thin no matter how much calcium you eat. The post Exercise is More Important Than Calcium Supplements for Bones tells more about this. Bone demineralization is rapid and serious in astronauts in microgravity (Collapsing Astronaut Gives Healthy Reminder).

How you use your muscles causes them to pull differently, giving evidence about the kind of habitual motion. More interesting is that when you are active, your bones grow and shape themselves to facilitate your motion. An example of interest to readers following the posts on squatting is that people who habitually sit for normal daily life in full squat grow "squatting facets" on their lower leg bones. These are small areas on the bone that quickly grow to make squatting more comfortable. At one point, it was a debate in anthropology that squatting facets were a marker of someone of Asian ancestry, until it was found that others who squat also grow them, and that squatting facets disappear when the person adopts a Western sitting habit of chairs and no longer squats. Babies of all races can have them.

Someone who habitually slouches can change the shape of their bones, eventually deforming them. This can occur in the spine, knees, hips, ankles, shoulders, feet, toes - everywhere you pressure your bones. Changing positioning habits to healthier ones can, in many cases, reshape the bones back to healthier shape. Think of braces on your teeth. It's human bonsai. In cases of extreme dystrophies of the muscles, someone who sits without function of their trunk muscles to hold the spine upright, can eventually deform their spine until their ribs sit on their hip bones. How are you sitting right now? The recent post What Does Stretching Do? explained a bit of why stretching isn't reducing injuries. People are stretching, then exercising and going about daily life in bent over positions that rub and grind the joints and soft tissue.

You literally shape your own health. Use the posts throughout this Fitness Fixer blog to do healthy exercise in healthful positioning so that your bones will only tell good tales about you.

Labels: achilles stretch, aerospace, ankle, arm, feet, forensic, injury, leg stretch, osteoporosis, posture, scuba, sitting, squat, toes

Permalink | 1 Comments| Email Post

Post your comment

Functional Achilles Stretch

Sitting in full squat with heels down can be healthful and useful. Squatting for daily life is a built-in Achilles stretch, more effective and functional than the standard "lunge and lean stretch" against the wall, or lowering one heel from a step or ledge. Better Achilles Tendon Stretch shows one Achilles tendon stretch that is effective and quick. Sitting in a full squat is another. Rising from the squat adds functional leg muscle strengthening and balance.

I took the photo, above left, in an airport in Asia. The man was easily sitting to work on his laptop during the hour before boarding. Others were similarly sitting with laptops and mobile devices to get work done. Elders squatted that way to rest.

Achilles Stretch in the Bathroom introduced the full squat as a functional normal daily action used in many countries for resting, washing, gardening, working, washing, toileting, chatting on the phone, and other activities, and gave an idea of how to try it. Save Knees When Squatting explains how keeping the heels down rather than lifting heels to rest on the ball of the foot is safer for the knees. Reader Mim supplied a wonderful link in the comments for a great little film of the Asia squat. More Fun Squatting tells a funny squatting story.

People new to squatting may find their Achilles tendons are too tight to bend in this normal manner. Reader Ivy of New Zealand offered to demonstrate one easy way to practice this stretch in a safe way, and sent the photo at right.

Keep both heels down while holding something sturdy in front. Straighten your arms and lean back to shift weight away from the knee joints.

Squatting can be a nice stretch for your lower back too. I have been working, off and on, for some years on the interesting finding that slight forward spine rounding when just sitting on your heels in the squat (no weights) does not load the spine to the extent of sitting on your behind in a chair. Be smart about trying it or not if you already have damaged knees. When rising, make sure to keep knees back over your feet, not sliding forward, which loads the knee joint, or inward at an angle (narrower than your feet), which can twist the joint. Either action can grind against the meniscus and cartilage.

Done properly, it should feel good on the Achilles and calf, lower back, be good exercise, not hurt the knees, and become an option for a functional stretch and even normal sitting ability.

Labels: achilles stretch, balance, leg strength, leg stretch, lower back, sitting, squat, strength, stretch

Permalink | 7 Comments| Email Post

Post your comment

Get Better Exercise From Your Chair

How many times do you get in and out of a chair everyday? It could be enough for a fair amount of exercise, if you use muscles instead of leaning forward (photo shows terrible sitting) and flopping down.

At a medical conference last year, a speaker droned endlessly about back surgery (even though Studies Say Back Surgery Not Needed, and you can Fix Disc Pain Without Surgery) and the usual tedious exercises that people must do three times a week (then they do unhealthy movement all day that causes the pain in the first place, or do their exercises in back damaging ways - Common Exercises Teach Bad Bending). An obese physician arriving late plodded to a chair next to me. She laboriously bent over, bending wrong to put her bag on the floor. She slowly bent over forward, bending wrong again to retrieve two cushions from the bag. She bent over wrong again to place one cushion on the chair seat, then again for the second cushion for the chair back. She turned her back to the chair, bent far forward, bent her knees a small amount, so slowly, then slammed her backside down to the chair with a WHUMP. She sat rounded for the rest of the lecture about surgery for disc herniation. Sitting and bending rounded forward is the major cause of disc "disease." To easily avoid disc pain and surgery see Disc Pain - Not a Mystery, Easy to Fix.

What to do instead? Any time you start to sit, check if you lean forward and stick your backside out. You shouldn't need to lean far forward to sit, or rise from sitting. If you have to lean, it is usually a sign of weak legs. If your heels come up as you bend your knees, your Achilles tendons are tight (or you have functional bad Achilles habits). You shouldn't (ordinarily) need to use your hands to sit or rise. Your balance and legs should do the work. Do you sit down heavily, not using leg and hip muscles to decelerate? Why jolt your spine and give up free calorie burning at the same time? Try this now to see:

Stand up, ready to sit -

1. Start to sit, keeping both heels down on the floor.
2. Don't lean forward. If you lean, correct it by tilting your hip under and raising your upper body to be straighter.
3. Keep both knees back over your heels. Don't let knees slide forward.
4. Keep knees parallel over your heels. Don't let knees sway inward.
5. Notice how you have to use far more leg and hip muscle, and the pressure of holding your body weight comes off the lower back and knee joints.
6. Notice if you reach for the arm rests, or other support, out of habit. Use your leg muscles instead.
7. Sit down lightly.

Start to rise from sitting -

1. Notice if you lean far forward or raise your heels or jut your chin forward.
   
2. Notice if you need to push off your hands.
3. Notice if your knees comes together. Don't let them.
   
4. Change how you rise to put both heels down on the floor, push off your whole foot including heels, and use your leg muscles to rise while holding your upper body more upright without jutting your neck and chin forward.

This is not a bunch of strange rules for sitting, or a weird, contrived exercise, it is just basic concepts for normal healthful daily movement.

The previous post explains why it is not healthy for your back or the best exercise to lean and stick out in back - Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats? It covered good knee placement too, so check that if you avoid healthy movement because of knee pain.

Exercise is still thought of as something you go and "do" instead of moving in real life. It's silly to do 10 squats in a gym or using your chair and then go back to unhealthy movement each time you sit or bend during the day. Have comfortable healthful movement all day. Sit and rise easily. That is exercise as a lifestyle.

Labels: achilles stretch, disc, leg press, leg strength, lower back, sitting, strength

Permalink | 0 Comments| Email Post

Post your comment

Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?

A commonly repeated phrase in fitness books and programs is "tuck your hip under" and "tuck the tail" for good posture. Many people know this, repeat this, teach this, write articles about it, then stick their behind too far out in back and overly-arch their lower back, doing just the opposite, when they squat, bend to pick things up, sit in a chair, and exercise (photo at left). It can result in unhealthful compression on the spine joints called facets and on surrounding soft tissue.

Sticking the behind too far out overly arches the lower back. Overarching shifts weight onto the spine joints and compresses them in a bent-backward position, increasing eventually risk of back pain and joint damage. Another issue is that if you cannot squat without sticking out in back or leaning your upper body far forward, it is a sign that your thighs are weak, your Achilles tendons are tight, you are not using your ab muscles, your balance is poor, or all four.

So why do so many programs teach to stick far out in back? It is well known that the opposite problem of tucking too much and rounding forward contributes to back pain. People hear this and assume that the opposite, over-arching backward, will counteract that. They exaggerate the arch. It initially seems to "work" because by over-arching backward when lifting, you can lift more because you shift some of the work off your muscles and onto your lower spine (and sometimes knees). The muscles do less, so it seems easier. Competition lifters use it to lift more, regardless of the pain and injuries it causes later on.

It is trend-breaking news to say don't stick your backside out to squat. I know. It goes against what fitness organizations and pop-science exercise books teach. I know. Try this to see for yourself:

• Stand upright with feet side-by-side, comfortably apart.
• Face both feet in the same direction as your knees.
• Bend both knees, keeping both heels down on the floor and over your feet, not sinking inward or bowing outward.
• Look down and see if your knees cover the sight of your toes.
• If you can't see your toes because your knees are forward blocking the view, pull your knees back (keeping them bent) until you are still squatting but can see your toes.
• Keep your upper body as upright as you can.
• Now, here is the point about the lower back - notice if you stick your behind far out in back. It may be habit or that you don't have the leg strength or balance or your Achilles tendon is so tight that your heels come up from the floor. Instead, tuck the bottom of the hip under, just enough to bring the spine to "neutral." A small inward curve remains when you have neutral spine, but not a large one.
  
• Raise your upper body to be more vertical, while staying in the squat.
• Notice how you have to use far more leg and hip muscle, and the pressure of holding your body weight comes off the lower back and knee joints.

That is healthy bending for all bending - to do squats for exercise, to pick up clothes from the floor, to get pet dishes, look in the refrigerator, get the laundry, pick up the kids, to sit down in a chair, and so on. You will get a far better workout for your thighs, keep weight off your knees and spine. It is healthier to squat instead of bending forward to pick things up. But you don't want to cause the opposite problem by overly arching backward (sticking out the behind) either.

Another point in spine health and exercise is not to "tighten" your abdominal muscles to squat or lift. It is not healthy or useful to tighten abs for any movement. It is trend-breaking news to say "don't tighten." I know. It goes against what fitness organizations and pop-science exercise books have been teaching. I know. Tightening is not what supports your back. Moving your back out of unhealthy stuck-out position, explained in this post, to a position not arched back or rounded forward is what prevents spine pain and injury. That is how you support your back - not by tightening. The previous post Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine explains this. Here are fun exercises, without tightening or the forward bending of crunches or Pilates, that causes so much back pain, that are more effective too:
Abdominal Muscle Exercise - Better, Different, Not What You Think
If Better Abdominal Muscles Are Your New Year's Resolution, Try This
Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Techniqu
Change Common Exercises to Get Better Ab Exercise and Stop Back Pain

Have fun being part of this big and healthy change in fitness.

Labels: abdominal muscles, achilles stretch, lordosis, lower back, myths, neutral spine, squat, strength

Permalink | 10 Comments| Email Post

Post your comment

Save Knees When Squatting

American baseball catchers have the occupational risk of meniscus tears in their knees. Yoga practitioners of certain squatting moves like "the eagle" and the hindu squat are more likely to get the same meniscus cartilage tears and early joint wear and tear. Asians who routinely squat for so many activities of daily life don't get these injuries. The difference is keeping your heels down and your feet facing in the same direction as your knees.

Sitting in a full squat with your heels down and your weight back does not pressure the knees the way squatting with heels up does. Keep both heels down and keep your weight back on your heels.

People who are not accustomed to squatting often find that they are too tight in the Achilles tendon to sit all the way down. Many of these same people do Achilles tendon stretches every day, or at least they do a motion commonly taught as an Achilles stretch, but which barely stretches the Achilles. The "lunge and lean," is the least effective Achilles stretch. The post Better Achilles Tendon Stretch tells why and gives a better stretch to do instead. The squat is another good Achilles tendon stretch. It is a lifestyle stretch for the Achilles and lower back, and a hip, leg, and shin muscle strengthener. You get healthful natural exercise from regular daily life. Even if you can't get down to full sit, bend properly with both heels down for daily bending and you will get a free Achilles tendon stretch every time you bend, which is many many times a day. Holiday Leg and Abdominal Exercise tells more on this.

The trains here in Thailand have the luxury of a bathroom, including a squatting bowl. You can tell new tourists here. They are afraid of the bathroom. When we lived in Japan, even the gleaming modern Bullet train, the Shinkansen, had a spotlessly clean squat fixture. Train bathroomsgive you balance practice too, swaying with the train as it takes you to the next adventure.

Photo by Jolie Bookspan

Labels: achilles stretch, fix pain, knee, leg press, leg strength, leg stretch, squat, yoga

Permalink | 28 Comments| Email Post

Post your comment

More Fun Squatting

The previous post, Achilles Stretch in the Bathroom, explains how and why the squat is a functional lifestyle exercise, good to stretch the Achilles tendon and get strong, shapely leg muscles. By keeping both heels down and your weight off the front of your foot, it can be safe for the knees. The large amount of built-in leg exercise you get from routinely sitting and rising from sitting this way strengthens the hip, thigh, and knees.

At the left is a photo of a sign that is common here in Asia. The sign instructs people who are accustomed to squatting how to use the strange seat. The drawing marked with an X shows someone standing with both feet on the seat and squatting over the bowl. That is marked as incorrect use. The user is instructed to sit touching the seat. I asked some of the locals what they thought of the "sit and touch the seat" method. They shuddered, pointing out how silly that was.

Beside strengthening and stretching the legs, squatting is a cleaner way to sit, since only your feet touch the surface. It is common to see people waiting for a bus at the street curb, sitting, not with their behind on the curb, but sitting in a squat so that only their feet touch.

Squat toilets vary, but are often clean. You leave your shoes outside and wear bath shoes. Even some public toilets have public rubber shoes thoughtfully provided.

Western sit-down fixtures are becomming more common, as more wealthy tourists demand them and locals adopt less physical lifestyles. Our friends living here told us the story of a family who decided to convert their shining clean indoor squat facility to Western plumbing. They purchased a standard raised bowl and seat. They left on a short tip while a workman installed it. When they returned, the man was proud of his installation. He excitedly told the people it had been strange at first, but he did a fine job. He led the people to his finished work and said that at first he was puzzled by the height of it, but figured out to dig a deep hole. He buried the new, shiny toilet exactly up to the seat to become the familiar floor level.

Photo by leeroy09481

Labels: achilles stretch, fix pain, knee, leg strength, leg stretch, squat, stretch

Permalink | 0 Comments| Email Post

Post your comment

Achilles Stretch in the Bathroom

In the airport, an obvious tourist arriving here in Asia proudly waved a travel pack of toilet seat covers and claimed to be ready for the germs of travel. Another tourist nearby announced that it was a problem for him that women couldn't go to the bathroom outdoors. I asked him why he thought they couldn't. He said it was because they can't stand up to go, and someone needed to invent a tray so that they could. I asked him if men sat to pass their bowels. He seemed surprised when he realized that everyone does natural things the same way. Both men and women have been sitting to "go" for thousands of years before plumbing and raised seats were invented.

All over Asia, Africa, India, the South Sea continents and islands, and even in places in Europe and the Americas, men, women, and children routinely and easily sit in full squat to eat, wait, talk on the phone, rest, relax, wash, and do other activities of life. The tourist with her seat covers may quickly find that squatting is cleaner than touching a seat. Many people who first encounter Western sit-down plumbing think it is unclean and barbaric. The squat is a functional and excellent leg strengthener and Achilles tendon stretch. People in their 80s and older who routinely squat have strong legs and healthy good knees, and can easily rise from the floor.

Would you like to try the squat? (Use your brain to be safe to try things or not, if you have damaged knees):

• Keep both heels down (right drawing) as you bend both knees, which protects your knees.
• One way to practice the squat if your Achilles tendons are too tight, is to hold something in front of you, like a counter or sink, and bend both knees as much as you can with both heels down.
  
• While holding the support in front of you, lean back with both arms straight so that your weight stays over your whole foot and heels, which moves your weight off your knee joints and back onto your leg muscles.
• Try to balance and sit without holding on. If you find yourself falling backward, or if your heels come up (left drawing), it is likely that your Achilles tendons are too tight for this normal activity. Put one or both hands behind you to lean on (not in the squat bathroom but just to practice).

Every time you bend around the house, use a small squat with both heels down, described in Bending Right is Fitness as a Lifestyle and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending. You will strengthen your thighs and hip, develop healthful bending that stops knee pain, strengthen your shins, and stretch your Achilles tendons each time. As this routing bending strengthens and stretches your legs, progress to lower and lower bending until you can comfortably sit in a squat. Have fun.

Copyright drawing and more fun and functional stretching in Stretching Smarter Stretching Healthier

Labels: achilles stretch, balance, knee, leg strength, leg stretch, squat, stretch

Permalink | 3 Comments| Email Post

Post your comment

Holiday Leg and Abdominal Exercise

Many people are taking down Christmas trees even as the Russian and other Eastern Orthodox families are putting theirs up for Christmas, coming this Saturday Jan 6th. The Russian Snow Girl (Snegurushka), and DedushMoros (Father Frost) have already come to visit. S nastupaiushchim Novym godom i s Rozhdestvom Khristovym - Happy New Year!

Here are two lifestyle strengtheners (and a free Achilles tendon stretch) to build into your fitness as a lifestyle for 2007:

If you would like to get strong legs for the New Year, don't bend over wrong to lift things (upper drawing, left). From now on, make all your bending the way that strengthens your thighs and at the same time prevents back and knee pain (upper drawing, right). Keep your upper body upright and bend your knees. Prevent knee pain and get better use of your leg muscles by keeping both knees down and back over your heels. Each time you keep both heels down while doing healthy bending, you will also get a built-in Achilles tendon stretch. The post How Often Should You Be Healthy? tells more on good bending.

If you want to stop "mystery" lower back pain for the New Year, check to see if you lean backward when you reach upward (lower drawing, left), carry things, or when you are just standing. Leaning back creates overarching of the lower back called hyperlordosis, which pinches and pressures the soft tissue and joints of your spine. People with this kind of pain feel they need to lean over forward or sit to relieve the pain. Instead of doing remedies for pain, it is smarter and healthier to stop the cause of the pain.

The "hip tuck" or "pelvic tilt" to reduce overarching and straighten the spine (lower drawing, right) is described in the post Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique. The muscles you use to move your spine out of unhealthy overly arched position and into straighter position are your abdominal muscles. By simply standing and moving with a healthier spine position, you get free exercise for your abdominal muscles. "Tightening" the abs is not what exercises the abs or prevents back pain. Tightening also does not let you breath or move properly. Tightening is not how to have healthy abdominal function. Instead, use the abdominal muscles to stop overarching and maintain healthy position while going about your daily life and exercise. The post, If Better Abdominal Muscles Are Your New Year's Resolution, Try This, shows how.

If your New Year's Resolution is to have a healthier low back, Achilles tendons, and abdominal muscles, you can do that all at once during your regular daily activities.


Drawing copyright by Jolie Bookspan

Labels: abdominal muscles, achilles stretch, disc, fix pain, knee, leg press, leg strength, leg stretch, lordosis, lower back, squat, strength

Permalink | 0 Comments| Email Post

Post your comment

Ancient Shoe Exercise for Hip Stretch and Balance

Readers have been asking what happened to the weekly reports of my martial arts classes. Others wanted to hear about my other classes including yoga. My martial arts students continued becoming skilled and disciplined. Next semester I will post some of the fun drills they do to build natural strength, discipline, and flexibility using themselves and each other instead of weights and equipment. In my yoga classes we learn that the poses themselves are not what gives good posture and focus. We learn what healthy positioning is, then apply it to how to move for daily life after walking out of the class.

In my sports medicine practice, I regularly see yoga teachers as patients for back, knee, and neck pain. That is because several yoga moves are not good for anyone - just as not all food is healthful. Many moves are fine, but other traditional poses injure joints, even when done "right" (or especially when done right), like bending over from a stand or a sitting position, whether the back is rounded or straight. We omit those moves and use others that are better stretches without the degenerating forces on the lower back and neck discs, for example, Healthier Hamstring Stretching. You don't have to injure yourself to get exercise. Fitness is supposed to be healthy.

This week in yoga we did a fun, effective hip stretch. We stood on one foot and reached for the other ankle crossed over the bent standing knee (drawing at left). When we do this, we practice the daily healthy position of keeping the upper body upright and straight, with the chin in, not craned forward. One new student was not happy with my class. She was used to sitting on the floor in classes she ordinarily took. She was peeved that we did so much standing. Although people call yoga "mind and body," she didn't like that we used the body. Although people frequently say that yoga is about understanding and light, she whined and complained and cursed me under her breath for most of the class. She wanted to know why I was making everyone do an extreme and bizarre movement.

I told the class it was healthy and happy to do this move every day. I pointed to my crossed foot and spoke the name of this ancient move - "Putting on shoe."

I hope you will try this too, to get a normal and healthy hip stretch and better balance everyday. Remember that most of the world stands to dress - the ones lucky enough to have shoes. Stand up now and try it. You will get free balance, healthy hip stretch, and leg strengthening every day from daily life. When you get good at this fun move, keep your ankle crossed and bend the standing leg enough for you to reach to the floor to retrieve your other shoe or sock. Keep your chest up and your back straight to prevent practicing unhealthful rounded position. Even though this one bends over, it does not put force on the lower back discs for several reasons, including that one foot is raised.

Have fun adding new healthy movement to your New Year. Send me photos and stories of how you make your life better by fixing your fitness to be functional and healthy.


Drawing, copyright from the book Stretching Smarter Stretching Healthier

Labels: achilles stretch, balance, hip, leg strength, leg stretch, strength, yoga

Permalink | 1 Comments| Email Post

Post your comment

Getting Stronger Without a Gym

I often hear from trainers, and read in exercise books, that you cannot get stronger without lifting weights. They say that body weight is not enough. Then I watch the trainers and read what the exercise books say to do to strengthen. Often the weights they teach to lift are far lighter than the resistance your muscles get from moving your own body during a real life activity.

I see women in exercise classes lifting little two and five pound hand weights, then bend over wrong to put the weights down and bend over wrong again to hoist up their 20-pound handbag. I see knee pain patients in rehab centers with two and three-pound weights strapped on their ankle, sitting down to do little leg raises. Or, they pull stretchy bands with their leg. Then they get up and walk away with injurious body mechanics, letting their knees and ankles sag inward because they are not using their leg muscles to stop it. The unhealthy sagging grinds away joint cartilage and prevents full use of the leg muscles. They don't understand why their knees, ankles, and feet still hurt even when they "Do their exercises."

Your body weight is the most important thing you need to lift. Following are things to start with, to strengthen without a gym or equipment. The main idea of these activities is not to "do" them as an exercise 10 times, but to use them to retrain your muscles how to hold your body in healthy position, then use that healthy positioning for all daily life:

1. Hold a pushup position, called the plank, described in the post Change Common Exercises to Get Better Ab Exercise and Stop Back Pain. Understand that the point of the plank is to learn how to hold your spine straight without sagging under your body weight. I see people doing the plank all the time in gyms and fitness classes, with their bottom hiked up in the air and their low back looking like a hammock, sinking under their body weight. That is not the normal lower back curve. It is injurious overarching. Done poorly this way, the plank does little to strengthen and just pressures your lower back. Done well, the plank is excellent to strengthen your wrist. The wrist is neglected in fitness, and the resulting weakness is a common source of injury. I will post more about wrists. Do the plank every day - that is how helpful and important it is. If you can't even hold up your own body weight, you may have serious weakness.

2. Use the squat for daily bending, described in the post How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending. The point is to use this healthy bending all the time instead of bending wrong. In posts to come, I will show another way for healthy bending using a lunge position with one leg in front and the other in back.

3. If you can't sit and rise from the floor without your hands, you are too weak and tight for ordinary daily life. Try Quick and Easy Strength and Balance Exercise. Also practice getting up from your chair (safely) without using your hands or leaning forward.

4. Stand to put on your hosiery, pants, and shoes: Better Balance by Christmas.

5. Hang from a chining bar, a branch, a pipe, a doorjamb, or any secure overhead. Don't worry if you cannot do full pull-ups, just hold on and hang. When you can do that, hang for as long as you can from a bent-arm position, and begin trying to raise yourself (do a pull-up). Maybe you will need to start by stepping up on a box to help raise yourself, and letting yourself slowly lower without using the box. Work up to full pull-ups. If that is easy, use fewer fingers to hold on.

6. Try the Quick and Fun Arm and Body Strengthener.

When the above body weight activities become too easy, do them carrying functional weight, such packages, children, books, and other common things. It is crucial to health and independence to be able to lift and move your own body weight. In posts to come I will show you how to do more with these body weight activities for more strength and fun being active. Until then, do these every day and send your photos and stories of how you got stronger and happier.

Make it your New Year's Resolutions to be strong for real life in real ways.


Photo by quailwood

Labels: abdominal muscles, achilles stretch, aging, arm, balance, fix pain, hamstring, hand, knee, leg press, leg strength, leg stretch, lower back, shoulder, side, squat, strength, stretch, upper back

Permalink | 0 Comments| Email Post

Post your comment

Better Balance by Christmas

I heard a radio program about yoga for senior citizens. The yoga program directors made the usual statements about yoga helping strength and balance. Then they said something that seemed at odds with their goal. They said, "If your balance is poor, do the moves sitting down or hold on to the wall." The very thing that you need to improve your balance is to practice standing and (safely) not holding the wall. If you sit and hold on, you prevent practicing balance.

Balance that helps your normal daily life is easy to improve at any age. All you need is to stand up and balance. Balance is quickly lost with sitting and disuse.

How does balance practice help you? You have receptors in all your joints that sense positioning. They can tell if you are about to fall. They tell your body to send signals to your muscles to steady you. If you don't use your balance sensors with balance practice, they become slow and unable to sense positioning well. You may tip over far enough to fall before your receptors sense it and can tell your muscles to pull you to upright position. Balance practice also improves your muscles. Without balance practice, your muscles become too slow and weak to prevent you from tipping over and falling. If you have let yourself become tight, brittle, and weak from lack of general exercise, you may strain, tear, or break something from a fall that would not have otherwise caused any harm.

Years ago when I left working in the hospital to go into private practice in sports medicine, I found that by making house calls you learn the reasons for people's pain and injuries that you will never see in a hospital or clinic exam setting. It was the first time I ever saw anyone have to sit to put on or take off their shoes. Here are a few quick, functional (real life) ways to improve balance:

• Stand up when you put on your socks or hosiery.
• Stand up to put on your pants. Lift one leg in front of you, keep your upper body comfortably straight and upright, and slide on each pant leg.
• Stand up to put on your shoes. Try two ways: holding the foot in the air front of you to place the shoe, and by crossing the ankle on the opposite knee.
• For more balance, after putting on one sock or shoe, remain standing on one foot and do a small squat on one leg to reach the other sock or shoe on the floor.

If you can't stand to dress yourself, and you have at least one working leg, you may be too tight and weak and unsteady for healthy normal life. You don't need to go to a gym or "do exercises." Use balance skills as part of your daily life.

Photo by Manamanah. For more fun and functional real life balance activities see the books Fix Your Own Pain Without Drugs or Surgery and Healthy Martial Arts.

Labels: achilles stretch, aging, ankle, balance, feet, fix pain, holiday, leg strength, leg stretch, side, spirit, squat, strength, stretch, upper back, yoga

Permalink | 0 Comments| Email Post

Post your comment

Don't Confuse Exercise With Real Fitness

Reader Dr. Zoe Eppley e-mailed, "I have been trying to apply your "bending right" approach to my daily activities. I find my tight leg and hip muscles seriously limit my ability to squat. Could you please recommend some stretches that will help?"

I receive this inquiry often. People are realizing that they are too tight to move in healthy ways for normal everyday life. I hear it from instructors of aerobics, yoga, Plates, personal trainers, and many others. This is an important epiphany. If you are too tight to move in healthy ways, then it is likely that you spend every day of your life moving in tight ways that create pain and perpetuate tightness.

The good news is you do not need to "do" stretches and exercises. Keep bending right and you will get exactly the stretch and strengthening you need. My most important message that I stress in all my work about exercise is not to "do exercises" but get crucial, functional, effective exercise by mo